Medication-at-home pharmacy is an innovative method of medication management that is vital to the success of the health care system.
The concept of “aging in place” has grown more popular in recent years, not only as a preferential care setting for the aging population, but also as a necessary one. This term means more individuals who have chronic medical conditions are choosing to stay in their homes rather than go into an assisted living or rehabilitation facility. By 2030, every baby boomer in the United States will be 65 or older. With increasing life expectancies, the projections of cognitive disability, and the rising cost of long-term care, there will not be enough space in facilities to fit our aging population, let alone properly care for them.
The rising popularity of “aging in place” has led to a necessary pivot in the health care field, with organizations putting in-home support services in place and providers leaning on the historically underutilized pharmacist. Almost every chronic condition is treated with medication, more commonly multiple medications.
With 20% of hospital readmissions being related to errors in medication—up to 70% of which are considered preventable—the success of at-home care falls onto pharmacies providing enhanced care services. The clinical expertise of a pharmacist combined with access to patients and medication management solutions are now putting pharmacists into the care continuum and having real impacts on patient health and quality metrics.
Medication reconciliation is one of the perks of having a pharmacist involved in patient care. The terms means that the pharmacist will have a “bird’s-eye view” of all the medications a patient takes and can catch overlaps or possible adverse reactions between drugs.
New at-home pharmacy providers make medication reconciliation a priority, not only at time of patient onboarding, but on a continual basis. This way, prescriptions are not simply being filled and billed without oversight and pharmacists are available to provide clinical pharmacy care, meaning today’s at-home patients can expect the same attention to detail they would experience if they were living in a facility.
In addition, pharmacy management technology has stepped up to allow care management at the pharmacy level, with care planning, access to lab and vaccine data, and integration with electronic medication administration records and electronic health records.
One of the biggest risks of patients to at-home health is also one of the largest responsibilities individuals have when managing their chronic conditions: taking their medications properly. The World Health Organization states that medication adherence is more effective on health outcomes than the actual treatment itself. Typical adherence to medication needs to be above 80% for treatment success, but with polypharmacy, forgetfulness, and other socioeconomic barriers, only 50% of individuals with chronic diseases are estimated take their medications as prescribed.
At-home pharmacies provide advanced medication adherence solutions to combat this risk and better support patients. First, all the medications for a given patient are synchronized to 1 fill day and cycled into a continual fill date, which takes the confusion of refills off patients and caregivers. Those medications are then packaged into date-and-time stamped pouches that can be customized with languages, color, and pictures and organized to specific patient needs.
This multidose medication packaging—the same type that can be found at a facility’s med-pass—places all medications that are to be taken at the same time (ie, morning) together, eliminating the need for self-organization methods; the method is proven to increase medication adherence. These specialized pharmacies then provide delivery services so patients receive their medication at their door. Lastly, the pharmacy team is in continual contact with the patient throughout their cycle for coaching, counseling, and any other care initiatives patients need to support adherence to their medications.
Communication and Collaboration
Today’s medical teams work in tandem with one another to offer the best care possible to their patients, with medication-at-home pharmacies being included in the care continuum. These pharmacists often have the most access to patients, continually filling their medication and communicating with them. Providers have started to trust pharmacists to act as liaisons between them and their patients, administer vaccinations, and counsel on disease states, while some organizations have partnered with high-performing pharmacy providers to include the expertise of a pharmacist on their care team through collaborative practice agreements.
The health care world has realized that when a person chooses to age in place, the care team needs to utilize every part of the industry to their fullest potential. At-home pharmacies can take an active role in care management and provider communication. This advanced role increases health outcomes, reduces hospital readmissions, and provides doctors with a clinical resource to mitigate potential problems quickly.
Better Health (and Cost) Outcomes
The health care world is changing. Aging individuals want to stay in their homes, even while battling chronic conditions. Through innovative health care models, patients are now able to receive long-term-care levels of service and advanced support in their home.
With the at-home approach to pharmacy—including pharmacist/provider partnerships, advanced medication reconciliation, and pharmacist-led care management—better health outcomes are sure to follow. However, it’s not only health outcomes that are affected.
The at-home pharmacy model makes long-term care more affordable to patients, while also reducing payers’ total health care spend. In a country where over 50 million people are 65 or older, out-of-pocket costs for facility care are expected to exceed $266 billion by 2028, and plans and payers are under pressure with capacity and resources, a solution that is preferred for patients that also eases the burden and spend of the health care system is essential.
Medication-at-home pharmacy is not a quick fix for medicine organization or a model that every pharmacy can jump into. It is an innovative method of medication management that is vital to the success of our health care system.